Impact of ketamine infusions on healthcare utilization and chronic pain: a comparative effectiveness study with insights from real-world data.

Previous studies provide conflicting evidence for ketamine's effectiveness in treating chronic pain, in the context of limited real-world evidence to augment clinical trial findings. We conducted a comparative effectiveness study with real-world data to assess the impact of ketamine infusions on pain-related healthcare utilization, to bridge the gap between clinical trials and real-life care. We identified 118 subjects who received intravenous (IV) ketamine infusions for chronic pain between 2018 and 2022. Using the University of Pittsburgh's patient outcomes repository for treatment registry, we created a propensity score-matched control cohort of 118 subjects. Real-world data from the University of Pittsburgh Medical Center healthcare network was analyzed to compare unexpected pain-related healthcare utilization, including emergency room visits, urgent care visits, and hospital admissions. Utilization was assessed 6 months before and after ketamine infusion and compared with the matched control cohort. The ketamine cohort demonstrated a decrease in unexpected healthcare utilization 6 months after treatment compared with 6 months prior, while the control cohort showed an increase during the same period. Ketamine treatment was associated with a 45% reduction in pain-related visits compared with the control cohort (p<0.001). IV ketamine was more effective than conventional therapy in reducing unexpected pain-related healthcare utilization for over 6 months in patients with chronic pain. Our study highlights the value of using real-world data and comparative effectiveness research to supplement clinical trials and enhance our understanding of the possible effects of outpatient ketamine infusion therapy.